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Improvement of Care & Outcome

DIABETES AND USE OF HOSPITAL CARE IN THE NETHERLANDS

Silvia de Vries, Jessica Bak, Vincent Stangenberger, Michel Wouters, Max Nieuwdorp, Theo Sas, Carianne Verheugt

Use of hospital care among Dutch diabetes patients. Diabetes Obes Metab . 2023 Aug;25(8):2268-2278.

Increasing rates of obesity in an aging population are leading to increasing prevalence of diabetes, which is already affecting >10% of the global population. Diabetes healthcare costs are enormous with 966 billion USD spent in 2021, expecting to increase to an astronomical 1.05 trillion USD in 2045. Healthcare use, mainly hospital care, is much higher among people with diabetes (PWDs) compared with people without diabetes. In the Netherlands 1.2 million people are affected by diabetes, costing €1.6 billion in 2016, with €1.3 billion attributed to complications. Not much is known about hospital use on a PWD level. This study, co-authored by Theo Sas of Diabeter, aimed to assess healthcare resource use, hospital expenditure and cost-driving factors among adult PWDs in Dutch hospitals, employing real-world reimbursement data.

In the Netherlands insurance companies receive invoices from hospitals based on ‘diagnosis treatment combinations’ (DTC), which are predefined packages of healthcare services each with their own DTC code, depending on medical specialty, diagnosis and related treatment. Hospitals archive these DTC-invoices. A database with benchmark information from 65 hospitals (88% of all Dutch hospitals) is serviced by LOGEX. Diabetes DBC claims of 193,840 adult PWDs treated in 65 hospitals between 1-1-2019 and 31-12-2019 were analysed.

Key findings:

93% were treated in secondary hospitals: 54% were male, median (range) age was 65.0(18.0-105.0) years, socioeconomic status was low in 37.6% and high in 27.6%
Total hospital costs for all PWDs were €1,352,690,257 (1.35 billion) per year
Only 9% was associated with treatment of diabetes
Yearly costs per PWD were €6978 (of which €1109 were diabetes care costs)
Hospital costs of PWDs exceeded that of the general Dutch population three- to sixfold
Total hospital costs increased with age
Diabetes-related costs decreased with age
Of all PWDs, 51.3% received care related to cardiovascular complications
Micro- and/or macrovascular complications increased hospital costs (1.4-5.3 times higher)

Concluding, the authors state

"The hospital resource use of Dutch diabetes patients is high, with alarge burden of cardiovascular complications. Resource use is rooted mainly in hospi-tal care of diabetes-related complications, not in the treatment of diabetes. Earlytreatment and prevention of complications remain imperative to taper future health-care expenditure on patients with diabetes." -

Please click here for the PubMed link.

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